Correlation between the change of CT value of adipose tissue in the walking area of mesentery and activity of Crohn's disease

HU Xiao; DING Jiejie; QIAN Nianxia; LIU Xiaodong

doi:10.20258/j.cnki.1006-9011.2025.11.020

Abstract：Objective To investigate the change of CT value of adipose tissue in the walking area of mesentery in patients with Crohn's disease(CD)and its relationship with disease activity.Methods A total of 43 patients with active CD were se-lected,including 23 patients with mild active stage(mild group)and 20 patients with moderate active stage(moderate group),and 25 patients with suspected inflammatory bowel disease(control group)were selected at the same time.Intestinal mucosal in-flammation was confirmed by colonoscopy biopsy,and CT imaging(CTE)was performed after the group was enrolled,and the original images were reconstructed by multi-plane reconstruction technology.Different parts of the mesenteric walking zone,in terms of mesenteric root,superior mesenteric artery,inferior mesenteric artery,fat space within 5 mm around the diseased intes-tinal segment and vascular space outside 10 mm around the diseased intestinal segment,were selected as areas of interest.The CT values and ΔCT values of adipose tissue in different parts of the mesenteric walking area were measured in different stages,including ΔCT1 values in arterial phase and ΔCT2 values in normal scan period,and ΔCT2 values in venous phase and normal scan period.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of ΔCT values of adipose tissue in different parts of mesenteric walking area for moderately active CD.Results There were statistically significant differ-ences in the CT values of fat tissue in the walking area of mesentery in different parts of the three groups at the normal scan stage,arterial stage and venous stage(P<0.05).The CT values of fat tissue in mesenteric walking area at normal scan stage,arterial stage and venous stage in moderate group were higher than those in mild group and control group(P<0.05).There were signifi-cant differences in ΔCT1 and ΔCT2 values in the adipose tissue of mesenteric walking area among the three groups(all P<0.05).The ΔCT1 and ΔCT2 values of adipose tissue of mesenteric walking area in moderate group were higher than those in mild group and control group(P<0.05).The area under ROC curve of ΔCT2 value in the fat space around the diseased intestinal segment was the highest,reaching 0.958,and the best cutoff value was 16.50 HU.In this case,the sensitivity and specificity of ΔCT2 value in the prediction of moderately active CD were 90.0%and 95.8%.Conclusion With the increase of disease activity,the CT value of adipose tissue in the walking area of mesentery in patients with CD increases gradually.The ΔCT1 and ΔCT2 values of the adipose tissue in the walking area of mesentery in different parts have certain diagnostic value for moderately active CD,and the ΔCT2 values of the adipose space around the diseased intestinal segment have the highest diagnostic value.